CBS Evening News

Americans Grapple With New Health Care Law

A move by House Republicans to repeal the health care law is going nowhere. Even so, they passed a resolution today directing House committees to get to work on new health reform legislation. The vote was 253 to 175, with 14 Democrats joining the majority.

In the meantime, the reform plan President Obama signed into law last year is starting to kick in. CBS Evening News anchor Katie Couric puts that "In Focus."

"We went to the Los Angeles Forum," CBS News correspondent Bill Whitaker said. "We got there very early in the morning, 2:30 or 3 o'clock - and already was a line of people."

"The point of the event was to provide free medical care for people in need," Whitaker said.

In all, more than 5,000 people came. Ten months after the Affordable Care Act became law, many Americans still rely on charity like this. Implementing reform is just beginning.

"It was shocking. It was shocking to see that many people needing that level of care," Whitaker said.

"This is a rollout that doesn't even begin to producer insurance for people for three years," Gawande added.

The key date is 2014. That's when every American not covered by employers must buy health insurance or pay a fine. This larger pool of insured Americans is essential to pay for the most ill and expensive patients. For the next three years -- 17 of every 100 Americans will remain uninsured. That number should drop to 9 in 2014.

"This is a long process," Gawande said. A process that requires turning a 900 page law that few people have actually read - into a better health care system.

"The job of implementing health reform belongs to HHS, the Department of Health and Human Services," CBS News correspondent Wyatt Andrews said. "They have an entire division now to do that. The concrete building on Independence Avenue is where the new coverage rules are being defined.

"There is a special interest lobbying frenzy going on right now over the definition of the word 'essential,'" Andrews said. "Is obesity treatment? Is that essential? Infertility treatment?"

As the government sorts out those questions, Americans are still trying to figure out what the law means to them.

In our latest poll, 56 percent say the law has not been explained well. Just 13 percent say they have seen any benefit - even though the most vulnerable are now protected.

"Children cannot be denied insurance because of a pre-existing condition," CBS News medical correspondent Dr. Jon LaPook said. "At no age can insurance companies cancel your insurance because you get sick. And children can be covered under their parent's policy up until age 26."

A gap in Medicare coverage for drug costs is being closed. And experimental programs to reward doctors for better efficiency and outcomes are underway. But it will take six more years to phase in all 91 of the law's major components.

CBS News chief White House correspondent Chip Reid said, "That's why the White House has its entire war room operation up and running again. They understand that part one was getting it passed. Part two is protecting it."

The law is vulnerable because of the complex way it tries to fold 30 million uninsured people into the system - while getting a handle on costs. By 2019, the law is expected to save the economy $143 billion. But the country's health care tab at that point will still reach $4.6 trillion - or 20 percent of the economy. That's compared to 17 percent now.

"This law does more to address coverage that it does to address cost," CBS News senior business correspondent Anthony Mason said. "Business' argument for years has been the problem is cost - and that is what is killing the economy."

Californians are not the only ones still being battered with jaw-dropping hikes.

"There has been incredible outrage here in California," Whitaker said. Many, many people thought health care reform would stop these kinds of increases."

Republican leaders are making sure that does not go unnoticed.

"We will continue this fight until Obamacare is no longer the law of the land," Rep. Michele Bachmann said yesterday.

"One congressional expert that I spoke to put it this way. He said, 'they're not going to be able to kill this bill. The best they can do right now is a series of flesh wounds,'" CBS News congressional correspondent Nancy Cordes said.

That damage could be inflicted by choking off funding for programs that support the law. But a greater threat is a legal cyclone over the horizon.

Storm Brewing

More than 20 states are now suing the federal government over the rule that makes insurance coverage mandatory.

"They say Congress simply exceeded its authority when it passed this wide-ranging law," CBS News chief legal correspondent Jan Crawford said. "It requires residents all of these states to actually buy insurance or face a tax."

Court Rulings in favor of the states may cripple reform.

"That storm is going to get stronger and build and build until it gets to the Appeals Courts and eventually with the full force of a hurricane, it's going to hit the United States Supreme Court," Crawford said.

"I have no question that we will discover ways that can control costs and improve quality of care for people," Gawande said. "Whether we're going to take those lessons depends entirely on politics and that's scary. That's the reality."